Analysis of MRI Examinations Requested from the Emergency Department: Cost Analysis with Clinical Pre-Diagnosis and Outcome Comparison

Mustafa Alpaslan; Necmi Baykan

Article Details

Analysis of MRI Examinations Requested from the Emergency Department: Cost Analysis with Clinical Pre-Diagnosis and Outcome Comparison

Authors:

Mustafa Alpaslan | Necmi Baykan

Publisher:

Bursa Uludağ University

Main Topics:

Acil Tıp

Journal:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 1, pp.95-102

Document Type:

Article

Publication Date:

5/2024

Document Language:

Turkish

Document ID (Org No.):

2001317390

pISSN:

1300-414X

Keywords:

Abstract:

 The aim of this study was to discuss the necessity of this radiologic request by comparing the presenting complaints of the patients with the final diagnosis of the patients in whom diffusion magnetic resonance imaging was requested in the emergency department. This study was retrospectively performed on patients who underwent diffusion magnetic resonance imaging in the emergency department over a three-month period. The time of presentation month, age, gender, and complaint were evaluated. It was determined whether the imaging was ordered by a general practitioner or a specialist physician. Demographic data were analyzed comparatively according to the presenting complaint and final diagnosis. Definitive diagnoses made by general practitioners and emergency medicine specialists were compared. Patients hospitalized in the ward or intensive care unit were compared according to hospitalization diagnosis. 530 patients were evaluated in the study.56.9 of the patients were female. The mean age was 63.918.04 years and the age range between 61-80 years was the age range in which the most imaging was performed 44.1 and ischemia was seen 47.The most common reasons for imaging were headache 16.2, regional numbness 15.1 and impaired consciousness 12.3.Ischemia was seen in 14.8 of patients.Hypertension and coronary artery disease were the most common comorbidities in patients with stroke.The most common presenting complaints of patients with ischemia were loss of limb strength 47.4 and slurred speech 14.Imaging was ordered by general practitioners with a rate of 78.5. Emergency medicine specialists diagnosed ischemic stroke 28.9 more often than imaging consultants. In our study, the cost of diffusion magnetic resonance imaging was 128790  4860 in the three-month period. In addition, the cost of diffusion magnetic resonance imaging without pathology was 110409  85.7. According to the results of this study, we think that general practitioners unnecessarily order diffusion magnetic resonance imaging in patients due to lack of professional experience and fear of malpractice. It is predicted that by being more selective in the light of clinical findings and literature data in ordering diffusion magnetic resonance imaging in the emergency department, unnecessary use and increased costs will decrease.

 The aim of this study was to discuss the necessity of this radiologic request by comparing the presenting complaints of the patients with the final diagnosis of the patients in whom diffusion magnetic resonance imaging was requested in the emergency department. This study was retrospectively performed on patients who underwent diffusion magnetic resonance imaging in the emergency department over a three-month period. The time of presentation month, age, gender, and complaint were evaluated. It was determined whether the imaging was ordered by a general practitioner or a specialist physician. Demographic data were analyzed comparatively according to the presenting complaint and final diagnosis. Definitive diagnoses made by general practitioners and emergency medicine specialists were compared. Patients hospitalized in the ward or intensive care unit were compared according to hospitalization diagnosis. 530 patients were evaluated in the study.56.9 of the patients were female. The mean age was 63.918.04 years and the age range between 61-80 years was the age range in which the most imaging was performed 44.1 and ischemia was seen 47.The most common reasons for imaging were headache 16.2, regional numbness 15.1 and impaired consciousness 12.3.Ischemia was seen in 14.8 of patients.Hypertension and coronary artery disease were the most common comorbidities in patients with stroke.The most common presenting complaints of patients with ischemia were loss of limb strength 47.4 and slurred speech 14.Imaging was ordered by general practitioners with a rate of 78.5. Emergency medicine specialists diagnosed ischemic stroke 28.9 more often than imaging consultants. In our study, the cost of diffusion magnetic resonance imaging was 128790  4860 in the three-month period. In addition, the cost of diffusion magnetic resonance imaging without pathology was 110409  85.7. According to the results of this study, we think that general practitioners unnecessarily order diffusion magnetic resonance imaging in patients due to lack of professional experience and fear of malpractice. It is predicted that by being more selective in the light of clinical findings and literature data in ordering diffusion magnetic resonance imaging in the emergency department, unnecessary use and increased costs will decrease.

 The aim of this study was to discuss the necessity of this radiologic request by comparing the presenting complaints of the patients with the final diagnosis of the patients in whom diffusion magnetic resonance imaging was requested in the emergency department. This study was retrospectively performed on patients who underwent diffusion magnetic resonance imaging in the emergency department over a three-month period. The time of presentation month, age, gender, and complaint were evaluated. It was determined whether the imaging was ordered by a general practitioner or a specialist physician. Demographic data were analyzed comparatively according to the presenting complaint and final diagnosis. Definitive diagnoses made by general practitioners and emergency medicine specialists were compared. Patients hospitalized in the ward or intensive care unit were compared according to hospitalization diagnosis. 530 patients were evaluated in the study.56.9 of the patients were female. The mean age was 63.918.04 years and the age range between 61-80 years was the age range in which the most imaging was performed 44.1 and ischemia was seen 47.The most common reasons for imaging were headache 16.2, regional numbness 15.1 and impaired consciousness 12.3.Ischemia was seen in 14.8 of patients.Hypertension and coronary artery disease were the most common comorbidities in patients with stroke.The most common presenting complaints of patients with ischemia were loss of limb strength 47.4 and slurred speech 14.Imaging was ordered by general practitioners with a rate of 78.5. Emergency medicine specialists diagnosed ischemic stroke 28.9 more often than imaging consultants. In our study, the cost of diffusion magnetic resonance imaging was 128790  4860 in the three-month period. In addition, the cost of diffusion magnetic resonance imaging without pathology was 110409  85.7. According to the results of this study, we think that general practitioners unnecessarily order diffusion magnetic resonance imaging in patients due to lack of professional experience and fear of malpractice. It is predicted that by being more selective in the light of clinical findings and literature data in ordering diffusion magnetic resonance imaging in the emergency department, unnecessary use and increased costs will decrease.

 Acil serviste difüzyon manyetik rezonans görüntüleme istenen hastalarda hastaların başvuru şikayetleri ile hastalara konulmuş olan kesin tanılarının kıyaslanarak bu radyolojik istemin gerekliliğinin tartışılması amaçlanmıştır. Bu çalışma retrospektif olarak üç aylık süreçte acil servisten difüzyon manyetik rezonans görüntüleme yapılan hastalar üzerinde yapıldı. Çalışmada hastaların başvuru zamanı ay, yaş, cinsiyet, başvuru şikâyeti değerlendirildi. Hastalarda görüntüleme isteminin pratisyen veya uzman hekim tarafından istendiği belirlendi. Hastalarda başvuru şikâyeti ve kesin tanılara göre demografik veriler karşılaştırmalı analiz edildi. Pratisyen hekim ve acil tıp uzmanları tarafından konulan kesin tanılar karşılaştırıldı. Servis veya yoğun bakıma yatan hastaların yatış tanılarına göre karşılaştırması yapıldı. Çalışmada 530 hasta değerlendirildi. Hastaların 56,9u kadındı. Yaş ortalaması 63,918,04 olup en fazla görüntüleme yapılan 44,1 ve iskemi görülen 47 yaş aralığı 61-80 arası oldu. Görüntüleme istemi en fazla baş ağrısı 16,2, bölgesel uyuşma hissi 15,1 ve bilinç bozukluğu 12,3 olan hastalardandı. Hastaların 14,8inde iskemi görüldü. İnme görülen hastalarda en sık hipertansiyon ve koroner arter hastalığı eşlik etmekteydi. İskemi görülen hastaların başvuru şikâyetleri en çok ekstremitede güç kaybı 47,4 ve konuşma bozukluğu 14 oldu. Görüntüleme istemi 78,5 oranla pratisyen hekimler tarafından yapılmıştır. Acil tıp uzmanları görüntüleme istemine göre 28,9 oranla daha fazla iskemik inme teşhisi koymuştur. Bizim çalışmamızda difüzyon manyetik rezonans görüntüleme maliyeti üç aylık dönemde 128790  4860  oldu. Ayrıca patoloji izlenmeyen difüzyon manyetik rezonans görüntüleme maliyeti 110409  85,7 oldu. Bu çalışma sonuçlarına göre pratisyen hekimlerin mesleki tecrübesizlik ve malpraktis korkusundan dolayı hastalarda gereksiz yere difüzyon manyetik rezonans görüntüleme istediklerini düşünmekteyiz. Acil serviste difüzyon manyetik rezonans görüntüleme isteminde klinik bulgular ve literatür verileri ışığında daha seçici olunmasıyla birlikte gereksiz kullanım ve artan maliyetlerin azalacağı öngörülmektedir.

Article Details

Analysis of MRI Examinations Requested from the Emergency Department: Cost Analysis with Clinical Pre-Diagnosis and Outcome Comparison

Authors:

Mustafa Alpaslan | Necmi Baykan

Publisher:

Bursa Uludağ University

Main Topics:

Acil Tıp

Journal:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 1, pp.95-102

Document Type:

Article

Publication Date:

5/2024

Document Language:

Turkish

Document ID (Org No.):

2001317390

pISSN:

1300-414X

Emergency Department

Diffusion Weighted Magnetic Resonance Imaging

Ischemic StrokeAcil Servis

Difüzyon Ağırlıklı Manyetik Rezonans Görüntüleme

İskemik İnme

Issues

Article Details

Analysis of MRI Examinations Requested from the Emergency Department: Cost Analysis with Clinical Pre-Diagnosis and Outcome Comparison

Authors: Mustafa Alpaslan | Necmi Baykan

Publisher: Bursa Uludağ University

Main Topics: Acil Tıp

Journal: Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 1, pp.95-102

Document Type: Article

Publication Date: 5/2024

Document Language: Turkish

Document ID (Org No.): 2001317390

pISSN: 1300-414X

Emergency Department

Diffusion Weighted Magnetic Resonance Imaging

Ischemic StrokeAcil Servis

Difüzyon Ağırlıklı Manyetik Rezonans Görüntüleme

İskemik İnme

Issues

Authors:

Mustafa Alpaslan | Necmi Baykan

Publisher:

Bursa Uludağ University

Main Topics:

Acil Tıp

Journal:

Uludağ Üniversitesi Tıp Fakültesi Dergisi Vol.50 Issue 1, pp.95-102

Document Type:

Article

Publication Date:

5/2024

Document Language:

Turkish

Document ID (Org No.):

2001317390

pISSN:

1300-414X